Chemotherapy at the end of life is compatible with dignified death and palliative care

Authors

  • Mario Hernan Diaz Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Argentina.
  • Luz Guadalupe Ibañez Ledesma Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Argentina.
  • Felipe Torres Gomez Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Argentina.
  • Marcelina Carretero Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Argentina.
  • Rosario Pasquinelli Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Argentina.
  • Bernardo Julio Martínez Servicio de Clínica Médica. Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. Central de Emergencias de Adultos. Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
  • María Florencia Grande Ratti Área de Investigación en Medicina Interna. Hospital Italiano de Buenos Aires. http://orcid.org/0000-0001-8622-8230

DOI:

https://doi.org/10.31053/1853.0605.v80.n2.37489

Keywords:

medical oncology, drug therapy, palliative care, death

Abstract

Introduction: Cancer treatment is increasingly aggressive. The aim was to estimate who died due to cancer, to report use of chemotherapy (CT) in the last 3 months of life, and to describe clinical-epidemiological characteristics of these patients.

Methods: We included a consecutive sample of deceased during 2017, affiliated to Hospital Italiano de Buenos Aires. Through manual review of medical helath records, they were classified according to the cause of death (cancer or other cause), validating diagnosis and baseline stage, performance status (PS). Prevalences with 95% CI are reported and descriptive statistics were used.

Results: A total of 2293 adults died, 59% women with a median age of 84 years old. There were a total of 736 deaths from cancer, representing 32% (95%CI 30-34). This last subgroup were 54% women, with a median age of 75 years, and only one patient had advance directives. Regarding the place of death, 80% were hospitalized (65% general ward and 15% intensive care units). The most frequent tumors were: lung, colorectal-gastric, hematological, and breast. A total of 390 patients received CT at the end of life (53%; 95%CI 49-57), 53% being women and with a mean age of 68 years. Regarding the underlying oncological disease: 81% had a solid tumor, 75% advanced stage, and mostly with poor/regular ability to perform daily activities (25% PS3 and 32% PS4, respectively).

Conclusion: There is a high frequency of CT at the end of life and deaths continue to be mainly in-hospital.

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Author Biographies

Mario Hernan Diaz, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Argentina.

Médico de Planta.

Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Argentina.

Luz Guadalupe Ibañez Ledesma, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Argentina.

Médica. Especialista en Medicina Interna.

Beca de Perfeccionamiento en Infectología.

Felipe Torres Gomez, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Argentina.

Médico.

Especialista en Medicina Interna.

Magíster en Investigación Clínica.

Marcelina Carretero, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Argentina.

Médica.

Maestranda en Investigación Clínica.

Rosario Pasquinelli, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Argentina.

Especialista en Medicina Interna

Actual becaria de perfeccionamiento de Sección Oncología, CEMIC, Argentina.

Bernardo Julio Martínez, Servicio de Clínica Médica. Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. Central de Emergencias de Adultos. Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

Médico, especialista en Medicina Interna.

Jefe de Central de Emergencias de Adultos.

Doctor en Ciencias de la Salud.

María Florencia Grande Ratti, Área de Investigación en Medicina Interna. Hospital Italiano de Buenos Aires.

Área de Investigación en Medicina Interna. Clínica Médica.

Médica asociada a Medicina Familiar.

Médica de guardia. Central de Emergencias de Adultos.

Hospital Italiano de Buenos Aires.

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Published

2023-06-30

How to Cite

1.
Diaz MH, Ibañez Ledesma LG, Torres Gomez F, Carretero M, Pasquinelli R, Martínez BJ, Grande Ratti MF. Chemotherapy at the end of life is compatible with dignified death and palliative care. Rev Fac Cien Med Univ Nac Cordoba [Internet]. 2023 Jun. 30 [cited 2024 May 19];80(2):93-8. Available from: https://revistas.unc.edu.ar/index.php/med/article/view/37489

Issue

Section

Original Papers